Provider Demographics
NPI:1497835151
Name:DELLINGNER, KRISTI MICHELLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:MICHELLE
Last Name:DELLINGNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 E. MADISON
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122
Mailing Address - Country:US
Mailing Address - Phone:206-328-7722
Mailing Address - Fax:206-328-7522
Practice Address - Street 1:4001 LAKE OTIS PKWY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5200
Practice Address - Country:US
Practice Address - Phone:800-769-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNURU1090363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNURU1090OtherSTATE LICENSE
AKNURU1090OtherPROFESSIONAL LICENSE
AKNURU1090OtherLICENSE
AK1497835151Medicaid
AK1497835151Medicaid